The Prevalence And Pattern Of Trachoma In Meru North District Kenya

Abstract

Todeterminethe prevalence and pattern of Trachoma in Meru north district, a communitybased study was conducted.Meru North, which was formally known as Nyambene,isone of the thirteen districts that make up Eastern Province. It borders MeruCentral District to the west and Tharaka District to the south. To the northeast is IsioloDistrictwhile Tana River and Mwingi Districts border the district to the southeasternside. A communitybased cross sectional observation study was conducted in two phases; from5th tois" July 2004 and 13th to 22ndJune 2005.Twenty sub locations were selectedusing systematic sampling method. The 1999 population and household censusvolume 1 was used as the sampling frame. The predetermined sample was distributedproportionately among the selected clusters. WHOgrades clinical presentation of trachoma as follows; Trachomatous inflammation withfollicles (TF), Intense Trachomatous inflammation (TI), Trachomatous Conjunctival scarring(TS), Trachomatous Trichiasis (TT) and Corneal Opacity due to Trachoma (CO). The target population was children aged 1-9 years and adults equal or above 15 years. ForTF we needed to examine at least 780 children and for TT we needed at least 990 adultsin the district. The sample coverage for both age qroups was above 100% thus the 95%confidence interval was achieved.The overall active trachoma prevalence in childrenaged 1-9years in Meru North District was 8.1 %( 70/880) with six sub locations havingprevalence of 5% and above. ThegrazingAgro-economic zone which occupies the drier part of the district had the highestprevalence of TF (14.2%) in the children aged 1-9 years. Boys had slightly more TF(4.5%)than girls (4.0%).The prevalence of TI was lower than that of TF in the District(5%),and all the sub locations. The prevalence of TT in Meru North District was 1 %( 11/1131 ).Majority of these cases were from the drier grazing zone. Only females wereafflicted by TT.The prevalence of CO in adults in the district was 0.4 %( 4/1131) indicatingthe burden of Trachoma caused blindness in the community. Only females wereafflicted by CO. There was no CO in children aged 1-9 years. Femaleadults were almost three times more afflicted by TS (prevalence 6.3%) than males(prevalence 2.2%).The minimum prevalence criteria to determine whether Trachoma is a public health problem is District TF prevalence 10%.and TT prevalence 1%and Sub location (clusters) TF prevalence 5% and TT prevalence ~1%. Thepresented data imply that Active trachoma is a public health problem in some Sub locations and therefore need for intervention as per the WHO recommendations.